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Herbs & Vitamin Supplements: A Word Of Caution

Complementary and alternative medicine (CAM) is important and popular, but ignorance about its potential harms can be dangerous to consumers. Physician passivity about the subject may also be doing consumers a disservice. Two interesting articles underscore this:

From the NIH:

In spite of the high use of complementary and alternative medicine (CAM) among people age 50 or older, 69 percent of those who use CAM do not talk to their doctors about it…

A telephone survey, administered to a nationally representative group of 1,559 people age 50 or older, revealed some reasons why doctor-patient dialogue is lacking. Respondents most often did not discuss their CAM use with doctors because the physicians never asked (42 percent); they did not know that they should (30 percent); or there was not enough time during the office visit (19 percent).


If you’re banking on a daily vitamin to make up for any deficiencies in your diet, you may be getting a whole lot more — or less — than you bargained for.

Of 21 brands of multivitamins on the market in the United States and Canada selected by and tested by independent laboratories, just 10 met the stated claims on their labels or satisfied other quality standards.

Most worrisome, according to president Dr. Tod Cooperman, is that one product, The Vitamin Shoppe Multivitamins Especially for Women, was contaminated with lead.

The same product also contained just 54 percent of the 200 milligrams of calcium stated on the label.

The analysis also showed that Hero Nutritionals Yummi Bears, a multivitamin for children, had 216 percent of the labeled amount of vitamin A in the retinol form, delivering 5,400 International Units (IU) in a daily serving. That’s substantially more than the upper tolerable level set by the Institute of Medicine of 2,000 IU for kids ages 1 to 3 and 3,000 IU for those 4 to 8.

Because too much vitamin A can cause bone weakening and liver abnormalities, the Yummi Bears “could be potentially doing more harm than good,” Cooperman said. “Vitamin A is one of those vitamins where you really don’t want to get too much.”

It’s important for physicians to educate themselves about CAM therapies and make it a part of their practice to ask their patients about the supplements they take. The Natural Standard databases are a great resource for physicians and consumers, and will be available soon at Revolution Health. Natural Standard, initially created by a team of Harvard physicians, systematically reviews the evidence behind the efficacy claims of various herbal remedies and supplements.

What resources do you use to evaluate the safety and efficacy of the herbs and supplements you’re taking?

This post originally appeared on Dr. Val’s blog at

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4 Responses to “Herbs & Vitamin Supplements: A Word Of Caution”

  1. nothing says:

    Another reason why medical doctors should not ignore vitamins and supplements but encourage their patients to discuss them in a non judgemental manner. There are number of pharmaceutical grade neutraceuctical companies that a knowlegable physician can be assured of their quality. This along with nutritional knowledge concerning vitamins and supplements helps to prevent the consumer from abuses as mentioned above. Unfortuntely, most physicians are content with being ignorant about what their patients are taking over the counter or from the health food store and or their patients too afraid of their comments if they did broach the subject with them.

  2. Bradly Jacobs MD MPH says:

    I agree with Dr. Nichols of the importance of becoming an INFORMED physician when it comes to dietary supplements (DS). While Natural Standard is a great resource for examining the reported safety and effectiveness of these substances, it does not provide information on the GMP (good manufacturing practices) of individual name brands. It is critical that consumer and health care professional understand that difference between GMP (which is specific to a name brand and even varies batch by batch) and reported safety/effectiveness of a dietary supplement.

    For example, despite the evidence for safety and effectiveness of glucosamine sulfate for knee pain (osteoarthritis), there is no guarantee that the product you buy off the self has the same quality as the products used in clinical trials…so what to do?
    1) pulls name brands off the shelf and evaluates the quality of the product case by case. I recommend them to all my patients.
    2) US Pharmacopaiea
    3) Buy the name brand product used in the clinical trial.
    4) Discuss your product choice and rationale with your physician (and in the process educate him/her about how best to choose a dietary supplement!).

  3. Jon says:

    Great post, Dr. Val. Thanks for the insight.

  4. Dr. Scherger says:

    Excellent comments Dr. Val. One thing I like best about Revolution Health is that we strive to present good Complimentary and Alternative Medicine while not compromising good medical practice and science. People can trust Revolution Health to provide CAM knowledge safely.

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